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This paper—which draws on inputs to, and discussions at, a methods development workshop—highlights the various concepts, methods, and tools that SoC researchers are considering to measure nutrition-relevant change in their respective countries. The focus is on nutrition-relevant policy and practice. These tools apply to 11 subthemes, which are to some extent sequential within policy/programming cycles: (1) assessing the nutrition problem, (2) stakeholder and institutional analysis/mapping, (3) understanding enabling environments for nutrition, (4) agenda setting and political commitment for nutrition, (5) policy formulation and policy processes, (6) multisectoral coordination, (7) implementation and vertical coherence, (8) scaling up, (9) assessing capacity, (10) assessing finance, and (11) monitoring, evaluation, and accountability. Examining these various methods and tools together allows for a holistic consideration of the processes that—while challenging to document and measure—play a key role in improving nutrition-relevant policy and practice, which, in turn, drives national achievement in reducing malnutrition. ; Non-PR ; IFPRI1; CRP4; Transform Nutrition; Capacity Strengthening; B Promoting healthy food systems; F Strengthening institutions and governance; Stories of Change in Nutrition ; PHND; A4NH ; CGIAR Research Program on Agriculture for Nutrition and Health (A4NH)

Malnutrition is a global challenge with huge social and economic costs; nearly every country faces a public health challenge, whether from undernutrition, overweight/obesity, and/or micronutrient deficiencies. Malnutrition is a multisectoral, multi-level problem that results from the complex interplay between household and individual decision-making, agri-food, health, and environmental systems that determine access to services and resources, and related policy processes. This paper reviews the theory and recent qualitative evidence (particularly from 2010 to 2016) in the public health and nutrition literature, on the role that agriculture plays in improving nutrition, how food systems are changing rapidly due to globalization, trade liberalization, and urbanization, and the implications this has for nutrition globally. The paper ends by summarizing recommendations that emerge from this research related to (i) knowledge, evidence, and communications, (ii) politics, governance, and policy, and (iii) capacity, leadership, and financing.

Malnutrition in all its forms continues to be a massive global challenge, and the past decade has seen a growing political attention to addressing malnutrition in different contexts. What has been largely missing so far, and is in growing demand from countries, is tangible, practical and rigorous insights and lessons (from other countries or contexts) on how to translate this burgeoning political momentum into effective policies and programme implementation strategies – and ultimately impact on the ground. This new climate of learning from experience and evidence led to the launch in 2015 of the Stories of Change initiative. This series presents a second wave of studies from six countries (Tanzania, Rwanda, Vietnam, Ghana, Burkina Faso, Nigeria,) and three Indian states (Chhattisgarh, Gujarat, Tamil Nadu). These provide clear evidence combined with compelling narratives on what drives success in addressing all forms of malnutrition – evidence that is necessary for turning global momentum into actual results on the ground. This introductory Opinion is published with the first set of papers. It will be followed by a thorough synthesis of papers as a conclusion of the Series. We hope that the lessons embedded in these Stories of Change will inform and inspire the deliberations and outcomes of the UN Food Systems Summit and the second Nutrition for Growth Summit to be held this year, and the actions of those in the global food and nutrition system working for positive change. ; PR ; IFPRI3; ISI; POSHAN; Transform Nutrition West Africa; CRP4; Stories of Change in Nutrition ; PHND; A4HN; SAR ; CGIAR Research Program on Agriculture for Nutrition and Health (A4NH)

This paper starts by reflecting on the concept and measurement of women's empowerment and then reviews some of the structural interventions that aim to influence underlying gender norms in society and eradicate gender discrimination. It then proceeds to review the evidence of the impact of three types of interventions—cash transfer programs, agricultural interventions, and microfinance programs—on women's empowerment, nutrition, or both. ; Non-PR ; IFPRI1; CRP4; Transform Nutrition ; PHND; A4NH ; CGIAR Research Program on Agriculture for Nutrition and Health (A4NH)

Despite decades of action to reduce global malnutrition, rates of undernutrition remain stubbornly high and rates of overweight, obesity and chronic disease are simultaneously on the rise. Moreover, while volumes of robust research on causes and solutions to malnutrition have been published, and calls for interdisciplinarity are on the rise, researchers taking different epistemological and methodological choices have largely remained disciplinarily siloed. This paper works to open a scholarly conversation between "mainstream" public health nutrition and "critical" nutrition studies. While critical nutrition scholars collectively question aspects of mainstream nutrition approaches, they also chart a different way to approach malnutrition research by focusing on politics, structural conditions, and the diverse ways people make sense of food and malnutrition. In this paper, we highlight the key research agendas and insights within both mainstream and critical nutrition in order to suggest spaces for their potential conversation. We ultimately argue that global public health nutrition interventions might achieve greater success in more equitable ways if they are informed by critical nutrition research. We aim for this intervention to facilitate more substantial crossing of disciplinary boundaries, critical to forging more socially and environmentally just dietary futures in the global South and beyond.

The current study aimed to understand why child stunting and anemia (CS&A) rates declined in Ghana between 2009 and 2018, and which priority policies and programs will further improve nutrition outcomes. Trends and potential drivers of stunting (height-for-age z-score < -2.0 SD) and anemia (hemoglobin < 11.0 g/dL), and decomposition analysis of DHS data (2003 to 2014) were conducted. The quantitative evidence was triangulated with Net-Map analysis of nutrition stakeholder relationships and influence, desk review of policies and programs 2009–2019, and in-depth interviews with 25 stakeholders who provided additional insights to explain CS&A trends. Declines in stunting (29.6%) and anemia (14.1%) in children were observed at the national level, but with important subgroup variations. Decomposition analyses identified changes in the household, maternal, and child characteristics (including wealth, use of antenatal services, maternal education, and immunization) as correlates of anemia reduction. Stunting reduction was linked with changes in bed-net utilization, household wealth, and pregnancy care service utilization. Additionally, multiple policies and programs initiated/implemented across multiple sectors were considered potentially relevant to CS&A reduction over time, including those focused on infant and young child feeding, water and sanitation, social protection, and health care access. Initiation/strengthening of these interventions was stimulated by awareness creation and subsequently increased prioritization of stunting. However, program delivery was limited by deficits in government funding, perceived low priority of child anemia, low implementation capacity and coverage, and weak coherence across sectors. Reduced CS&A resulted from improved access to services implemented across multiple sectors, albeit limited by implementation scale and capacity. Further reduction in CS&A requires enhanced multi-sectorally coordinated actions and capacity. ; PR ; IFPRI3; ISI; DCA; 2 Promoting Healthy Diets and Nutrition for all ; PHND

Malnutrition in all its forms continues to be a massive global challenge, and the past decade has seen a growing political attention to addressing malnutrition in different contexts. What has been largely missing so far, and is in growing demand from countries, is tangible, practical and rigorous insights and lessons (from other countries or contexts) on how to translate this burgeoning political momentum into effective policies and programme implementation strategies – and ultimately impact on the ground. This new climate of learning from experience and evidence led to the launch in 2015 of the Stories of Change initiative. This series presents a second wave of studies from six countries (Tanzania, Rwanda, Vietnam, Ghana, Burkina Faso, Nigeria,) and three Indian states (Chhattisgarh, Gujarat, Tamil Nadu). These provide clear evidence combined with compelling narratives on what drives success in addressing all forms of malnutrition – evidence that is necessary for turning global momentum into actual results on the ground. This introductory Opinion is published with the first set of papers. It will be followed by a thorough synthesis of papers as a conclusion of the Series. We hope that the lessons embedded in these Stories of Change will inform and inspire the deliberations and outcomes of the UN Food Systems Summit and the second Nutrition for Growth Summit to be held this year, and the actions of those in the global food and nutrition system working for positive change.

After a period of relative success in generating political momentum to address malnutrition, there is an increasing urgency to focus on implementation and impact on the ground. This requires better documentation of the experiences of policymakers, nutrition leaders, program managers and implementers in making decisions on what to do in real time, such as coordinating and implementing multisectoral nutrition plans in dynamic country contexts. The goal of the Stories of Change (SoC) initiative is to foster and support such experiential learning by systematically assessing and analyzing drivers of change in six high-burden contexts (Ethiopia, Zambia, Senegal, Bangladesh, Nepal and Odisha, India) that have had some success in accelerating improvements in nutrition. While recognizing context-specificity, we unpack the key pre-requisites (commitment, coherence, accountability, data, leadership, capacity and finance) that fuel and sustain progress.

South Asia and sub-Saharan Africa are the two regions of the world with the highest concentration of undernutrition. The majority of the nutritionally vulnerable populations in both regions is dependent in some way upon agriculture as a primary source of livelihood. The agriculture sector and wider agri-food system is considered to be central to sustained progress in reducing undernutrition – and yet not enough is known about how to unleash this potential. Recent scoping assessments have also revealed a paucity of information on wider political, institutional and policy-related challenges relating to the agriculture-nutrition nexus globally. Contextualized research into policy processes and the political economy of agriculture and nutrition is needed to better characterize "enabling environments" for agriculture to benefit nutrition, and how these environments can be shaped and sustained. This study aims to contribute to filling this gap, by drawing upon evidence from a set of case studies in South Asia (India, Bangladesh and Pakistan) and eastern Africa (Ethiopia, Uganda and Kenya). In synthesizing results across countries, while recognizing important nuance and detail, we conclude by highlighting four key issues to be addressed. First, improving knowledge and perception of undernutrition and its links to agriculture, on the part of agricultural policymakers and programme managers. Second, generating system-wide incentives for decisions and actions to become more pro-nutrition. Third, developing transparent systems of accountability for nutrition-relevant action throughout the agriculture sector, through linking timely and actionable data and evidence with incentives. And fourth, cultivating and strengthening leadership and capacities at different levels, underpinned by adequate financing. ; UK Aid ; Department for International Development (DFID)

PR ; IFPRI3; CRP4; ISI; Stories of Change in Nutrition ; PHND; SAO; A4NH ; CGIAR Research Program on Agriculture for Nutrition and Health (A4NH)

Background: The Transform Nutrition (Transform) research consortium (2012-2017), led by the International Food Policy Research Institute, sought to generate evidence to inform and inspire action to address undernutrition in 4 high-burden countries (India, Bangladesh, Kenya, and Ethiopia) and globally. Objective: Within the context of the literature, this synthesis article brings together core findings of Transform, highlighting priorities for future research. Methods: This article uses a narrative approach to synthesize diverse study findings that collectively address Transform's three primary research questions: (1) How can nutrition-specific interventions be appropriately designed, implemented, scaled, and sustained in different settings?; (2) How can the nutritional impact of social protection and agriculture be improved?; and (3) How can enabling environments be promoted so as to use existing political and economic resources more effectively? Results: Highlights of Transform include (1) improved understanding of the relative effectiveness of different combinations of nutrition-specific interventions and the ways in which they can be scaled for maximal impact; (2) evidence that shows that social protection and agriculture need to be explicitly linked to nutrition in order to contribute to stunting reduction; (3) identification of key components of "enabling environments" for nutrition and how they can be cultivated/sustained; (4) research that examines ways in which leaders emerge and operate to change the political and policy landscape in different settings; and (5) "stories of change" that provide in-depth contextual knowledge of how transformative change has been driven in countries that have made inroads in reducing malnutrition. The conclusion highlights the contributions of the consortium and provides recommendations for future research.

IFPRI3; ISI; CRP4; POSHAN; Stories of Change in Nutrition ; PHND; A4NH; SAO ; PR ; CGIAR Research Program on Agriculture for Nutrition and Health (A4NH)